Health Psychology: A Biopsychosocial Approach

Psychology
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What are some major disparities in health-related beliefs and behaviors among different ethnic groups?

Aug 12th, 2015

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Different ethnic group have their own practices views and beliefs in heath.The current/modern health practies ,behaviours have been widely adopted among some ethnic groups while other ethic groups still practice their own according to their beliefs and culture.

Some of the common disparities are

a)  Effects of using medicine when someone is seek

b) poor health is a sigh of misfortune,that's a cording to African traditions and also some communities in India and china.

Disparity of personal development ,how the person was brought up .This determines the health condition will be affected in near future .

Some ethnic groups practice witchcraft ,the results are predicted to affect the health of that particular individual while some don't believe in that

Thank you ...will continue .be patient please

Please let me know if you need any clarification. I'm always happy to answer your questions.
Aug 12th, 2015



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In spite of significant advances in the diagnosis and treatment of most chronic diseases, there is evidence that racial and ethnic minorities tend to receive lower quality of care than non minorities and that, patients of minority ethnicity experience greater morbidity and mortality from various chronic diseases than nonminorities. The Institute of Medicine (IOM) report on unequal treatment concluded “racial and ethnic disparities in healthcare exist and, because they are associated with worse outcomes in many cases, are unacceptable.” 1 The IOM report defined disparities in health care as “racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention.” 1 Since the publication of the IOM report there has been renewed interest in understanding the sources of disparities, identifying contributing factors, and designing and evaluating effective interventions to reduce or eliminate racial and ethnic disparities in health care.

Three studies published in this issue of the journal provide new insight to the sources of and contributing factors to racial and ethnic disparities in health care. In the first study, Trivedi and Ayanian 2 conducted a cross-sectional analysis of 54,968 respondents to the 2001 California Health Interview Survey to assess the relationship between perceptions of health care discrimination and use of health services. Approximately 5% of respondents reported experiencing some form of discrimination. Those that reported discrimination were less likely to receive some preventive care services; however, adjusting for perceived discrimination did not eliminate the observed racial, gender, and insurance disparities in receipt of preventive care.

The second study by Huang et al. 3 compared the factor structure and the rates of endorsement and differential item functioning of the well-validated 9-item Patient Health Questionnaire (PHQ-9) depression scale among 5,053 white, African American, Chinese American, and Latino primary care patients. The factor structure of the PHQ-9 was consistent across ethnic groups although there was evidence of differential item functioning for some items. The authors concluded that the PHQ-9 measures a common concept of depression and is an effective detection and monitoring tool for depression in diverse populations.

The third study by Groeneveld et al. 4 measured racial differences in attitudes toward innovative medical technology in 171 white and black patients in an urban Veterans Affairs Medical Center. Respondents answered questions about general innovativeness (i.e., attitudes toward new concepts in general) and medical innovativeness (i.e., attitudes toward new medical drugs, devices, and procedures). There were no significant racial differences in general innovativeness, but whites had higher medical innovativeness and were more likely to accept new prescription drugs than blacks.

Although the findings of these studies are highly relevant, there are inherent limitations in most research studies on ethnic differences that need to be highlighted. There is good evidence that socioeconomic position is a stronger determinant of health-related outcomes than race. Several studies have shown that the effect of race/ethnicity on health outcomes tends to diminish significantly when socioeconomic position is controlled for and in some instances the race effect disappears. 5 This raises the question whether observed racial/ethnic disparities in healthcare are due to race and ethnicity, race or ethnicity, socioeconomic position, a combination of both, or a yet unmeasured factor.

The study of racial variations in health is driven by a genetic model that assumes that race is a valid biological category, that the genes that determine race are linked with the genes that determine health, and that the health of a population is determined predominantly by biological factors. 6 However, recent studies have shown that there is more genetic variation within races than between races and that race is more of a social construct than a biological construct. 7 Therefore, the concept of race although socially meaningful is of limited biological significance. 8 In addition to the limitations of race as a construct, there are problems with the validity and reliability of race as measured in most research studies. Methods for collecting data on race include self-report, direct observation, proxy report, and extraction from records. In general, self-reported race is most reliable and should be the preferred method. However, with the increase in the number of people that belong to multiple racial categories, it is increasingly difficult to classify individuals into 1 race category, which further complicates the interpretation of race effects in research studies.

Ethnicity is another variable that is commonly used in studies on health disparities. The Office of Management and Budget (OMB) has defined minimum standards for maintaining, collecting, and presenting data on race and ethnicity. 9 The standards include 2 ethnic categories, “Hispanic or Latino” and “Not Hispanic or Latino” and 5 racial categories: American Indian or Alaska native; Asian; black, or African American; native Hawaiian or other Pacific islander; and white. The concept of ethnicity is an attempt to further differentiate racial groups; however, like race, it carries its own historical, political, and social baggage. 10 The current definition of ethnicity is arbitrary and ill defined. For example, the term “Hispanic” includes over 400 million people from many different ethnic groups and subgroups, in more than 20 different countries. 11 Thus, trying to interpret what differences due to ethnicity really mean is always a challenge. In spite of these limitations, ethnicity when combined with race provides more information as long as researchers define their construction of it and justify its validity, reliability, and consistency. 10

The concept of culture as distinct from race/ethnicity has been proposed as a better explanation for differences in health behavior and health outcomes. 12 The definition and conceptualization of culture varies across disciplines. The United States Department of Health and Human Services Office of Minority Health defines culture as “integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.” 13 Culture in the context of health behavior has been defined as “unique shared values, beliefs, and practices that are directly associated with a health-related behavior, indirectly associated with a behavior, or influence acceptance and adoption of the health education message.” 14 Others have defined culture as “the learned and shared beliefs, values, and life ways of a designated or particular group which are generally transmitted intergenerationally and influence one's thinking and action modes.” 15 Although culture is a valid explanatory variable for racial and ethnic differences in health outcomes, researchers need to recognize that knowing someone's ethnic identity or national origin does not reliably predict beliefs and attitudes. 16 Rather, it is more important to specify the cultural traits that are being tested and include appropriate measures that capture such

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